Alcohol consumption and heart failure: a dose-response meta-analysis This is a protocol for a Cochrane Review (prototype). The objectives are as follows: Main objective To assess the effects of alcohol consumption on the progression to symptomatic (stage C) heart failure in people at risk for heart failure (stage A) or in people with pre-heart failure (stage B). Secondary objectives To assess the effects of alcohol consumption on progression of left ventricular dysfunction in people with stage A or stage B heart failure. We will assess the effect of alcohol consumption on the development of...

Surgery for normal pressure hydrocephalus of unknown cause Key messages - Surgery to move excessive fluid away from the brain (cerebrospinal fluid (CSF)-shunting) likely improves walking speed and disability in the short term (less than six months post-surgery) in people with idiopathic normal pressure hydrocephalus (iNPH). - CSF-shunting did not cause any deaths, and repeat surgery was rare, but unwanted effects were common in the studies assessed. - More evidence on the effect of CSF-shunting on quality of life is needed. What is idiopathic normal pressure hydrocephalus? Normal pressure...

Comparing skin treatments for eczema Key messages: ° Strong corticosteroids, JAK inhibitors and tacrolimus 0.1% (all drugs that suppress the immune system) are consistently effective at reducing signs and symptoms of eczema. ° Unwanted effects, such as burning and stinging, are more likely with tacrolimus, pimecrolimus and crisaborole and less likely with corticosteroids; other unwanted effects, such as skin thinning, are only likely when strong corticosteroids are used long term. ° Given uncertainty about long-term effectiveness and safety, other factors such as availability, cost and...

How accurate are routine laboratory tests in predicting mortality and deterioration to severe or critical COVID-19 in people with SARS-CoV-2? What are routine laboratory tests? Routine laboratory tests are a set of commonly performed blood tests that provide information about a patient's health status. These tests can be used to identify disease or monitor health. What did we want to find out? It is important to identify patients, presenting at a doctor's appointment at an outpatient service or at the emergency department who are at high risk of developing severe COVID-19 disease or dying....

Is repetitive transcranial magnetic stimulation (rTMS) an effective and safe treatment for adults with post-traumatic stress disorder (PTSD)? Key messages • rTMS probably does not reduce the severity of PTSD symptoms by the end of treatment compared with placebo rTMS (sham stimulation) in adults. These findings, however, were limited by wide variations in how the treatment was delivered and the small number of participants. • Occurrences of serious unwanted effects in studies of rTMS for PTSD have been rare. • We need more studies investigating rTMS for PTSD in adults. It would be helpful if...

Cenobamate as an add-on treatment for focal epilepsy that does not respond to other long-term antiseizure medication Key messages - When added to one or more antiseizure medications, cenobamate is probably better than placebo (sham medical treatment) in reducing the frequency of epileptic seizures by at least 50% and in achieving seizure freedom in adults with focal epilepsy who do not respond to long-term antiseizure medications. - Cenobamate use probably causes more unwanted effects than placebo. What was studied in this review? Epilepsy is a disease of the brain where there is a...

Overall prognosis of index lung cancer recurrence or of second primary lung cancer in people with non-small cell lung cancer operated with complete resection This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: We aim to compare overall survival in people with recurrence and second primary lung cancer (SPLC) after lung cancer surgery. If survival differs between those people categorised as having index lung cancer recurrence and those categorised as having SPLC, it might be possible to identify the definition that has the best discriminatory capacity from the...

Are services organised to deliver care for people with atrial fibrillation (irregular heartbeat) better than usual (routine) care? Key messages • Organised care services for atrial fibrillation (AF) probably cause a large reduction in death from all causes and do reduce heart-related hospital admissions, but they probably make little to no difference to hospital admissions from all causes and may not reduce heart-related death compared with routine care (care provided as part of normal practice). • Organised care services for AF may not reduce complications such as stroke and mini-stroke and...

Minimally invasive versus open pancreatoduodenectomy in benign, premalignant, and malignant disease. This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of laparoscopic or robot-assisted pancreatoduodenectomy versus open pancreatoduodenectomy for people with benign, premalignant, and malignant disease. This is a protocol....

Are surgical interventions better than no treatment or non-surgical interventions for treating hallux valgus (bunions)? Key messages – Surgery may result in an improvement in pain, and a slight improvement in function and satisfaction with treatment compared with no treatment or non-surgical treatment. However, complications of surgery, such as wound infection, or hardware irritation requiring additional surgery, need to be balanced against its benefits in pain and function improvement. What is hallux valgus? Hallux valgus is a bony lump that forms on the inside of the feet (known as...

When is the best time to stop giving caffeine to newborns born preterm? Key messages • Currently, we do not know when to stop giving caffeine to preterm babies. • If we stop the caffeine too early, babies may have brief, sometimes repetitive, episodes when they have lower levels of oxygen in their blood. • We need to do more studies to find out the best time to stop giving caffeine to preterm babies. Why is caffeine given to premature babies? Caffeine is a stimulant used to prevent and treat apnea – when breathing repeatedly stops and starts – in preterm infants. Caffeine also seems to...

Exercises for the prevention of non-specific low back pain This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effects of exercise alone or exercise plus education compared with inactive control or education alone to prevent non-specific LBP. This is a protocol....

Eye movement desensitisation and reprocessing for survivors of life-threatening medical events This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of eye movement desensitisation and reprocessing (EMDR), a psychological intervention programme, on symptoms related to traumatic stress in survivors of life-threatening medical events. Secondary objectives: to evaluate whether the effects of EMDR differ according to the nature of the medical event (associated diagnosis or setting), measured outcome (post-traumatic stress disorder (PTSD),...

Robot-assisted versus conventional laparoscopic surgery for rectal cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of robot-assisted surgery for rectal cancer resection. This is a protocol....

Is 'TENS' (electrical nerve stimulation through the skin) an effective treatment for period pain and does it cause unwanted effects? Key messages • Overall, both high-frequency and low-frequency transcutaneous electrical nerve stimulation (TENS) may reduce pain compared with placebo (dummy treatment) or no treatment. • We are uncertain about the effects of high-frequency TENS compared with low-frequency TENS, the effects of both high- and low-frequency TENS compared with other treatments (acupressure, acetaminophen, interferential current therapy), and unwanted effects. • Future...

Treatment of liver cystic echinococcosis (hydatid disease) Key messages – We do not know if standard catheterization plus albendazole is more effective or safer compared to puncture, aspiration, injection and re-aspiration (PAIR) plus albendazole for treating cystic echinococcosis at specific cyst stages (CE1 and CE3a). – People undergoing laparoscopic (keyhole) surgery plus albendazole may have slightly fewer minor complications and shorter hospital stay than people who receive open surgery plus albendazole. We do not know if laparoscopic surgery plus albendazole may lead to fewer cases of...

Antimicrobial photodynamic therapy as an addition to standard treatment for gum disease around natural teeth or dental implants Key messages We are very unsure whether adding antimicrobial photodynamic therapy (aPDT) to standard treatment has any important benefits for adults with gum disease when compared to usual treatment alone. What is gum disease around natural teeth and around dental implants? Symptoms of gum (periodontal) disease include bleeding gums, swollen gums and bad breath. The infection can damage the soft tissues around the teeth, and in some cases people may lose their...

Shorter versus longer duration antibiotic regimens for treatment of culture-positive neonatal sepsis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the safety and effectiveness of shorter versus longer duration antibiotic regimens for the treatment of culture-positive neonatal sepsis with or without meningitis. This is a protocol....

Multisensory stimulation for promoting development and preventing morbidity in preterm infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of multisensory stimulation compared to any single sensory intervention or standard care for physical and neurological development in preterm infants. This is a protocol....

Trifocal compared with extended depth of focus intraocular lenses for people having cataract surgery What is the aim of this review? This Cochrane review aimed to assess the effects of artificial lenses placed in the eye after the removal of cataracts. In particular, we wanted to compare the outcomes of trifocal versus extended depth of focus (EDOF) intraocular lenses. Key messages People who have trifocal or EDOF (TECNIS Symfony) lenses implanted following the removal of their cataracts may experience similar levels of distance vision. People receiving trifocal lenses may have better near...